BILL NUMBER: AB 359 CHAPTERED
BILL TEXT
CHAPTER 435
FILED WITH SECRETARY OF STATE OCTOBER 11, 2009
APPROVED BY GOVERNOR OCTOBER 11, 2009
PASSED THE SENATE SEPTEMBER 10, 2009
PASSED THE ASSEMBLY SEPTEMBER 11, 2009
AMENDED IN SENATE SEPTEMBER 4, 2009
AMENDED IN SENATE JULY 15, 2009
AMENDED IN ASSEMBLY JUNE 2, 2009
AMENDED IN ASSEMBLY APRIL 15, 2009
INTRODUCED BY Assembly Member Nava
(Coauthor: Assembly Member Blakeslee)
(Coauthors: Senators Maldonado and Strickland)
FEBRUARY 23, 2009
An act to amend Section 30461.6 of the Revenue and Taxation Code,
relating to cancer.
LEGISLATIVE COUNSEL'S DIGEST
AB 359, Nava. Breast and cervical cancer: early detection
screening: digital mammography: reimbursement rates.
Existing law provides for the Medi-Cal program, administered by
the State Department of Health Care Services, under which qualified
low-income persons are provided with health care services, including
breast and cervical cancer services.
Under existing law, the State Department of Public Health
participates in a grant program through the federal Centers for
Disease Control and Prevention to provide breast and cervical cancer
early detection screening. Providers participating in the grant
program may only provide screening services to individuals whose
family income does not exceed 200% of the federal poverty level, and
provider rates are required to be identical to the rates under the
Medi-Cal program.
This bill would, until January 1, 2014, authorize, to the extent
permitted by federal law, digital mammography screening to be covered
when film or analog mammography services are not available from the
provider, to be reimbursed at the Medi-Cal film or analog rate.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 30461.6 of the Revenue and Taxation Code is
amended to read:
30461.6. (a) Notwithstanding Section 30461, the board shall
transmit the revenue derived from the increase in the cigarette tax
rate of one mill ($0.001) per cigarette imposed by Section 30101 on
and after January 1, 1994, to the Treasurer to be deposited in the
State Treasury to the credit of the Breast Cancer Fund, which fund is
hereby created. The Breast Cancer Fund shall consist of two
accounts: the Breast Cancer Research Account and the Breast Cancer
Control Account. The revenues deposited in the fund shall be divided
equally between the two accounts.
(b) The moneys in the accounts within the Breast Cancer Fund
shall, upon appropriation by the Legislature, be allocated as
follows:
(1) The moneys in the Breast Cancer Research Account shall be
allocated for research with respect to the cause, cure, treatment,
earlier detection, and prevention of breast cancer as follows:
(A) Ten percent to the Cancer Surveillance Section of the State
Department of Public Health for the collection of breast
cancer-related data and the conduct of breast cancer-related
epidemiological research by the state cancer registry established
pursuant to Section 103885 of the Health and Safety Code.
(B) Ninety percent to the Breast Cancer Research Program, that is
hereby created at the University of California, for the awarding of
grants and contracts to researchers for research with respect to the
cause, cure, treatment, prevention, and earlier detection of breast
cancer and with respect to the cultural barriers to accessing the
health care system for early detection and treatment of breast
cancer.
(2) The moneys in the Breast Cancer Control Account shall be
allocated to the Breast Cancer Control Program, that is hereby
created for the provision of early breast cancer detection services
for uninsured and underinsured women. The Breast Cancer Control
Program shall be established in the State Department of Public Health
and shall be administered in coordination with the breast and
cervical cancer control program established pursuant to Public Law
101-354.
(c) The early breast cancer detection services provided by the
Breast Cancer Control Program shall include all of the following:
(1) Screening, including mammography, of women for breast cancer
as an early detection health care measure.
(2) After screening, medical referral of screened women and
services necessary for definitive diagnosis, including
nonradiological techniques or biopsy.
(3) If a positive diagnosis is made, then assistance and advocacy
shall be provided to help the person obtain necessary treatment.
(4) Outreach and health education activities to ensure that
uninsured and underinsured women are aware of and appropriately
utilize the services provided by the Breast Cancer Control Program.
(d) (1) Any entity funded by the Breast Cancer Control Program
shall coordinate with other local providers of breast cancer
screening, diagnostic, followup, education, and advocacy services to
avoid duplication of effort. Any entity funded by the program shall
comply with any applicable state and federal standards regarding
mammography quality assurance.
(2) To the extent required or permitted by federal law, a provider
of breast cancer screening or diagnostic services may employ digital
mammography technology for the purposes of mammography screening and
diagnostic procedures that are conducted prior to January 1, 2014,
when film, otherwise known as analog, mammography technology is
unavailable. To the extent required or permitted by federal law and
notwithstanding paragraph (3) of subdivision (a) of Section 14105.18
of the Welfare and Institutions Code, the payment rate for all
mammography screening that is conducted prior to January 1, 2014,
shall be limited to the Medi-Cal payment rate for film mammography
screening.
(e) (1) The State Department of Public Health shall provide for
breast cancer screening services at the level of funding budgeted
from state and other resources during the fiscal year in which the
Legislature has appropriated funds to the department for this
purpose.
(2) Administrative costs of the State Department of Public Health
shall not exceed 10 percent of the funds allocated to the Breast
Cancer Control Program created pursuant to paragraph (2) of
subdivision (b). Indirect costs of the entities funded by this
program shall not exceed 12 percent. The department shall define
"indirect costs" in accordance with applicable state and federal law.
(f) Any entity funded by the Breast Cancer Control Program shall
collect data and maintain records that are determined by the State
Department of Public Health to be necessary to facilitate the state
department's ability to monitor and evaluate the effectiveness of the
entities and the program. Commencing with the program's second year
of operation, the State Department of Public Health shall submit an
annual report to the Legislature and any other appropriate entity.
The costs associated with this report shall be paid from the
allocation made pursuant to paragraph (2) of subdivision (b). The
report shall describe the activities and effectiveness of the program
and shall include, but not be limited to, the following types of
information regarding those served by the program:
(1) The number.
(2) The ethnic, geographic, and age breakdown.
(3) The stages of presentation.
(4) The diagnostic and treatment status.
(g) The Breast Cancer Control Program shall be conducted in
consultation with the Breast Cancer Research Program created pursuant
to subparagraph (B) of paragraph (1) of subdivision (b).
(h) In implementing the Breast Cancer Control Program, the State
Department of Public Health may appoint and consult with an advisory
panel appointed by the Public Health Officer and consisting of one ex
officio, nonvoting member from the Breast Cancer Research Program,
breast cancer researchers, and representatives from voluntary,
nonprofit health organizations, health care professional
organizations, breast cancer survivor groups, and breast cancer and
health care-related advocacy groups. It is the intent of the
Legislature that breast cancer-related survivors and advocates and
health advocates for low-income women compose at least one-third of
the advisory panel. It is also the intent of the Legislature that the
State Department of Public Health collaborate closely with the
panel.
(i) It is the intent of the Legislature in enacting the Breast
Cancer Control Program to decrease cancer mortality rates
attributable to breast cancer among uninsured and underinsured women,
with special emphasis on low-income, Native American, and minority
women. It is also the intent of the Legislature that the communities
served by the Breast Cancer Control Program reflect the ethnic,
racial, cultural, and geographic diversity of the state and that the
Breast Cancer Control Program fund entities where uninsured and
underinsured women are most likely to seek their health care.
(j) The State Department of Public Health or any entity funded by
the Breast Cancer Control Program shall collect personal and medical
information necessary to administer this program from any individual
applying for services under the program. The information shall be
confidential and shall not be disclosed other than for purposes
directly connected with the administration of this program or except
as otherwise provided by law or pursuant to prior written consent of
the subject of the information.
The State Department of Public Health or any entity funded by the
Breast Cancer Control Program may disclose the confidential
information to medical personnel and fiscal intermediaries of the
state to the extent necessary to administer this program, and to
other state public health agencies or medical researchers when the
confidential information is necessary to carry out the duties of
those agencies or researchers in the investigation, control, or
surveillance of breast cancer.
(k) The State Department of Public Health shall adopt regulations
to implement this act in accordance with the Administrative Procedure
Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of
Division 3 of Title 2 of the Government Code). The initial adoption
of implementing regulations shall be deemed an emergency and shall be
considered as necessary for the immediate preservation of the public
peace, health and safety, or general welfare, within the meaning of
Section 11346.1. Emergency regulations adopted pursuant to this
section shall remain in effect for no more than 180 days.
( l ) It is the intent of the Legislature in enacting
this section that this section supersede and be operative in place of
Section 30461.6 of the Revenue and Taxation Code as added by
Assembly Bill 478 of the 1993-94 Regular Session.
(m) To implement the Breast Cancer Control Program, the State
Department of Public Health may contract, to the extent permitted by
Section 19130 of the Government Code, with public and private
entities, or utilize existing health care service provider enrollment
and payment mechanisms, including the Medi-Cal program's fiscal
intermediary. However, the Medi-Cal program's fiscal intermediary
shall only be utilized if services provided under the program are
specifically identified and reimbursed in a manner that does not
claim federal financial reimbursement. Any contracts with, and the
utilization of, the Medi-Cal program's fiscal intermediary shall not
be subject to Chapter 3 (commencing with Section 12100) of Part 2 of
Division 2 of the Public Contract Code. Contracts to implement the
Breast Cancer Control Program entered into by the State Department of
Public Health with entities other than the Medi-Cal program's fiscal
intermediary shall not be subject to Part 2 (commencing with Section
10100) of Division 2 of the Public Contract Code.